Patients should increase screening

Cancer screening has taken a significant knock in both the public and private sector as a result of Covid-19.

This is according to stakeholders in both healthcare sectors who weighed in with their thoughts at a Campaigning for Cancer webinar discussion on June 11.

Head of the Centre for Clinical Excellence at Discovery Health Dr Noluthando Nematswerani said that despite creating benefits for screening, the uptake has not been at the level the medical scheme desires.

“We have seen a reduction in screening resulting in delayed diagnosis and initiation of treatment, resulting in an increase in the cost of care… At the peak of lockdown, screenings decreased significantly and still remain lower than before,” said Nematswerani.

She recommended that the scheme review its incentives in order to drive screening uptake as well as increase awareness. She also said that improved access to screening on a national level is needed.

Director of the Clinton Health Access Initiative in South Africa Dr Yogan Pillay said that 80 per cent of patients are dependent on the public sector for healthcare.

He said that cancer is the sixth main cause of mortality in the country which has significant limitations in cancer specialists.

“The cost of cancer treatment is astronomical and needs to be addressed,” said Pillay. He explained that Covid-19 has heightened the appreciation for inequalities in the country, giving the example of a woman who had to travel for many hours on public transport in order to receive treatment.

Pillay said it was important to strengthen services at all levels from prevention to palliative care and reduce the cost of diagnostics and treatment.

GM at Afrocentric Health Dr Samukeliso Dube agreed with Nematswerani that there is an increased burden due to the reduced uptake of screening services.

She said that oncology spend is increasing year on year with the largest cost being chemotherapy.

“Since the cost of treatment is high, we need to drive behavioural change and screening,” said Dube.

Senior manager at Government Employees Medical Scheme (GEMS) Tryphine Zulu said that as a society, we are more prone to curative than preventative care.

She said that in mid-lockdown, there was a sharp decline in the uptake of screening, but they have still not caught up to previous levels. Since the emergence of Covid, they have conducted approximately 13 000 less pap smears than expected.

Zulu said that higher options within the medical scheme have shown more interest in screening, despite all scheme options (including entry-level options) receiving the same screening opportunities.

“We need health systems that can cope not just with Covid, but can continue to provide care in spite of Covid,” concluded Zulu.